Background The Gosport independent panel reviewed 2024 deaths that occurred at The Gosport War Memorial Hospital between 1986 to 2001. According to the report, patient‘s families had raised concerns regarding the use of opioids and syringe drivers. Families felt that their loved ones had been given opioids and started on syringe drivers without a clear indication. These findings caused concern amongst patients and families around the use of opioids and syringe pumps. Opioids, antipsychotics and benzodiazepines play a fundamental role in symptom alleviation in palliative care and patients at the end of life. We have conducted a review of prescribing practice of opioids, antipsychotics and benzodiazepines via syringe pumps in patients under a specialist palliative care team in different care settings.

Method We looked into the indication of using opioids, benzodiazepines and antipsychotics in a syringe pump. We collected data on initial starting doses, prescription of dose ranges and dose escalations. This was a retrospective survey of patient medical records carried out at multiple centres in the North West of England including hospital, hospice and community settings. The participating organisations completed an online questionnaire.

Results We had a total of 267 responses. In the majority of cases, indications for syringe pumps were discussed and documented. Different prescribing practices were observed with regards to starting doses of medications, dose ranges and dose escalations. 5 mg of morphine (or dose equivalent) was the most common starting dose giving via a syringe pump in patients who were opioids na¯ve. 5 mg of midazolam was the most frequent dose prescribed initially in a syringe pump. Levomepromazine was the most frequent prescribed antipsychotic.

Conclusions This project has generated a vast amount of data. Further scooping exercise is needed to review practice in cases where specialist palliative care teams are not involved.